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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700352
Report Date: 03/18/2025
Date Signed: 03/19/2025 11:54:29 AM

Document Has Been Signed on 03/19/2025 11:54 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:HEALING PALMS HOME CARE, INC.FACILITY NUMBER:
374700352
ADMINISTRATOR/
DIRECTOR:		LINDA TALLEYFACILITY TYPE:
300
ADDRESS:7827 CONVOY CT. #407TELEPHONE:
(858) 933-4393
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY: TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
03/18/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:unavailableTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On 3/18/25 at 12:15 PM, an attempt was made to perform an unannounced inspection of Healing Palms Home Care Inc. Enforcement Analyst (EA) Adrian Mangina has made multiple attempts to conduct inspection and review of Home Care Organization records. EA attempted a visit during regular business hours, but no staff were present and no staff replied to message requesting staff attend inspection. A licensee or designee shall be continuously present during the Home Care Organization’s (HCO) posted business office hours. Any additional incomplete inspections may result in the issuance of civil penalties or possible license revocation. Please notify your Licensing Analyst and Enforcement of any changes to the HCO location or anticipated hours of operation.

Deficiency cited and was cited on the attached HCS809-D form and emailed to Licensee along with a copy of the HCS9058 Appeal Rights form.

LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
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Document Has Been Signed on 03/19/2025 11:44 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 03/19/2025 at 11:33 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814

FACILITY NAME: HEALING PALMS HOME CARE, INC.
FACILITY NUMBER: 374700352

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/21/2025
Section Cited
1796.52(c)
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An investigation or inspection conducted by the department pursuant to this chapter may include, but is not limited to, inspection of the books, records, or premises of a home care organization. A home care organization’s refusal to make records, books, or premises available shall constitute cause for the revocation of the home care organization’s license.
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This requirement was not met as evidenced by:Licensee has been unresponsive to multiple requests for updating office hours and was not present during regular business hours and did not was unable to provide staff files which poses a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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